Provider Demographics
NPI:1891078457
Name:HUNT, TINA TYSON (NP-C)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:TYSON
Last Name:HUNT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1005
Mailing Address - Country:US
Mailing Address - Phone:336-544-5400
Mailing Address - Fax:336-544-5401
Practice Address - Street 1:1309 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1005
Practice Address - Country:US
Practice Address - Phone:336-544-5400
Practice Address - Fax:336-544-5401
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005297363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health